Thursday, May 26, 2011

What?? Four Weeks Old? Nope, Five and a Half...

Can it really be that the girls are four weeks old? Well, they were when I started this post. Now they're five and a half weeks old. Wowzers!

I know... time flies at warp speed around here.

Last week marks another fun milestone: the girls are big enough to wear the cloth diapers that I have been so darn eager to use! So they are wearing some organic cotton pre-folds (Green Mountain Diapers) fastened with Snappis and a lavender Thirsties Snap-Wrap covers. To match the lavender trim on their sleep and plays, of course!

Both girls are getting chubby little thighs, finally. All of the eating they've been doing is really paying off. I was worried that all of the weight they have been gaining would end up on their cheeks, but they seem to be spreading it around and are filling out most adorably.

In news of the really odd, they both make this bizarre grunting sound as they wake up -- sort of like a 300lb trucker trying to give birth to a moose. They start with this noise about half an hour before a feeding. It is amusing during the day and disconcerting at night as it does, in fact, wake me wide awake. Scott? Not so much.

And, finally, some news of our poor forgotten older children. Well, they're not really forgotten -- we're all just currently preoccupied with the babies. Including the older kids -- I can't walk across a room holding one of them without Violet begging to "see the baby," which usually involves her sing-songing "Hi, cutie pie!" and kissing their cheeks. Milo is currently banned from cheek-kissing for the second time in the last month because he has had not one, but two fever-inducing colds. Yesterday's was brief, as in he woke up this morning running a 97.5, but he spent the Monday and Tuesday the week right after the babies' births home from school sick with a sinus infection. Sigh... Poor guy can't miss a germ, I swear.

Kid funnies: Milo has taken to throwing disco parties in his room. Which means that he turns on all of the fancy and flashing lights he can find and cranks "Do the Bartman" as loud as I can stand and we all dance.

And Scott relayed the following conversation he overheard Milo having with his best friend at the grocery store as Milo was deciding which fruit snacks to bring to his class party:

Milo's friend, as he points to a box of John Deere fruit snacks: Hey, this box says "Made with real fruit!"

Milo, as he gestures to a box of My Little Pony fruit snacks: Hey, these are made with real ponies!

Yesterday, we gave Violet her first ball glove and ball. It is, of course, pink and black. And she was ever so excited to use it. After dinner, Scott took the kids out to toss the ball around while I pumped (my second job, I swear). Three minutes later, Violet came back into the house, bawling so hard she was incoherent. Something about "Daddy" and "ball" and "my nose!"

Moments later, a hang-dog daddy came around the corner, sighing, "The first ball I tossed to her and I was only two feet away from her. She didn't move her glove at all..."

I'm not sure who felt worse.

Wednesday, May 18, 2011

A Promise to My Children

I promise that I will always love you, no matter what you do. There is nothing you can do that is unforgivable, nor that would make me stop loving you.

I promise that there really is nothing in the world more important to me than the health and safety of my family. You can test this as many times as you like, but I will always be your advocate.

I promise that you do not have to go into battle unarmed. I will teach you every way I know to defend yourself, and if that fails, I will be your shield.

I promise that no matter the problem, I want you to know that I will help you figure it out. Two heads and two hearts are far better than one.

I promise that if you think your heart is breaking, mine is already broken.

I promise that in your journey through life, you are not alone and never will be. Please be braced by my encouragement and never-ending support.

I promise that I will help you to understand the world so that when you need to make choices, you might be able to see the larger picture.

I promise that no matter how old you are and no matter where you live, I am only a step or a phone call away. Please wear out your dial pad calling me.

I promise that when things seem most scary, it is because you simply understand the consequences of actions and that the fear has to be there so that you stop and think.

I promise that every time I look at you, I see both the infant I carried and your future all wrapped up in more love than you could possibly imagine.

I promise that if you tell me you can't handle it, I will be there to carry you.

I promise that I will always love you. Always.

Friday, May 13, 2011

Pump It Up

So, the twins are almost four weeks old. Does that seem just insane to you? It does to me. I swear it was just yesterday we were buckling them into their car seats to bring them home from the hospital, grateful that they both passed the car seat check and that they actually fit in their seats. And now?

Well, the days seem endless, but the weeks are flying by -- if that makes any sense.

Before I explain, though, please let me take care of some bloggy business here. On April 18, likely as I was delivering the twins, Sanders over at Just a Dash of Sanders gave me a blog award. She is the mom of twin girls from near our old Penn State stomping grounds. Her gorgeous girls are a wee bit older than mine, so I'll be keeping an eye on her blog so that I can learn what's yet to come...

Also, while editing blog comments, it came to my attention that I was getting some substantial traffic from another blog, Multiples and More. I had joined the site several months ago and check it frequently because there are so many "been there, done that" multiple parents there it has some really great advice. Well, lo and behold, they had my blog featured on their front page under the "Expectant Parents" category. So here's my shout out and thanks for the highlight!

Back to the twin updates: Life is consumed by feeding them, whether it be actually feeding them, preparing to feed them, cleaning up from feeding them, planning feeding them, or pumping to feed them. They eat 7-8 times a day and it is currently taking an hour to prepare, feed, clean up, and pump. It is a full-time job.

I had hoped to nurse the twins as I was very successful nursing Violet (hello, the child weaned at 29 months!). But, according to the lactation consultants, they are true 37-weekers. Which means that they were just young enough that at first, nursing was such an effort that they tuckered out quickly. When coupled with high bili levels (especially Juliet's) and higher-than-preferred weight loss (Willa), we decided that they needed a bit of supplementation until my milk came in reliably. So, under the guidance of a lactation consultant, we started a tube-at-breast (TAB) feeding protocol on the day after they were born (Tuesday).

We were discharged on Wednesday from the hospital with borderline bili levels and borderline weight loss, both were to be checked on Thursday by the home visit nurse. We were still TAB feeding and learned that it was likely that we would need to supplement that way until the girls hit their due date. On Thursday, Juliet's weight loss had stabilized, but Willa's had not. On the other hand, Willa's bili levels were out of the range of concern, but Juliet's were not. In fact, the doctor prescribed a night on the bili bed, which was delivered to our house within the hour.

On Friday, after Juliet's night on the bili bed, we were back to the hospital for another bili level check for her and another weight check for both. Saturday was another weight check for both. Sunday was a doctor's appointment with bili levels (all OK) and a weight check (both girls gaining, finally).

At our Saturday weight check, I told the lactation consultant that I was pretty sure that both girls were sucking on the TAB and not nursing. This was confirmed when the LC did a weight before and after a feeding and the only thing in the baby was the supplement. Sigh... So we changed our game plan again and are offering the breast for as long as baby wants, then bottle feeding pumped milk or formula.

We've been sticking to that since then and both girls have surpassed their birth weights and are doing well. Juliet will attempt to nurse 80% of the time, with one or two feedings where she nurses for 6-8 minutes. Willa will nurse for 1-3 minutes at 1 or 2 feedings a day.

I am frustrated that I haven't been able to get them back to just my breast -- not frustrated with the babies or myself, but at the circumstances that got them off my breast in the first place. Willa's weight loss was rounding 11.5%, which is the starting-to-get-scary point. And Juliet spent one night on the bili bed, but if her levels hadn't improved, she likely would have been admitted to the hospital for more intensive therapy. I get that they both needed to eat and that they weren't quite equipped to nurse like champs from the beginning. But I'm still pretty sad about it because I really, really loved the bond that nursing created between me and Violet. I'm not sure that I'll be able to get either of them back to the breast full-time... sigh...

And then there's the pumping. I don't know how women who only pump can do it. By the time we get both babies fed, it's a 40 minute commitment. Then I pump for about 20 minutes. If I were producing enough to sustain both babies, I wouldn't begrudge a minute of that time. But right now, I'm only pumping enough to feed one baby. I'm trying everything I can think of to increase my supply: power pumps (ten minutes on, fifteen off three times in an hour), staying hydrated, drinking Mother's Milk tea (gives me diarrhea), and extra pumping sessions. And it is not reflecting at all in my pumping totals. In fact, the only thing it is doing is making my nipples crazy sore.

As much as I wish the feeding thing was different, I'll go on this way until I'm so tired I can't function. Or until I fall asleep and suck my nipples right off with the pump. I am feeling a little helpless about this situation, but really am doing my best.

Monday, May 9, 2011

Oooh! Lookie! Pictures... of Cute Kids!

Here are some photos of the babies' births and the first couple of days afterward.

Sunday, May 8, 2011

A Birth Story for Mother's Day

Go time...

If being wheeled into the OR wasn't strange enough, arriving there was akin to an out-of-body experience. There were a dozen people in there, not counting me or the on-call doc who was still stitching another mom who had given birth.

There were nurses for me, nurses for the baby, the anesthesiologist, a doc from the NICU whose name I didn't catch, me, Scott, the cameraman, and Scott's mom with a camera. Everyone was in gowns and masks except for me -- I was still in a hospital nightie with a bare bum which was resting in a swap of amniotic fluid.

Thankfully, though I could feel the increasing pressure with the contractions, I was not feeling the urge to push. I think that had I not gotten the epidural, Baby A might have been born in the hallway because the urge to push is pretty undeniable. Super Nurse asked if I was comfortable and could hang on until the doc got there. I said, "Yes. As long as he's not going to be an hour."

Then she asked if I wanted to do a practice push. I laughed and responded, "Not until there's someone here to catch!"

About that time, the someone to catch came in and introduced himself. If you recall, he met Scott earlier while I was sleeping. This time, I was very awake. He also asked for a practice push, so I did. About .5 seconds into the push he asked me to stop (which I could do, thanks to the epidural -- if I hadn't had the meds, Baby A would have hit the floor) and he quickly suited up.

Two pushes later at 11:47 a.m., Juliet Diana came into the world weighing 5lbs 8oz and measuring 19 inches long. Scott cut the cord and she was held aloft so that I could get a quick peek at her before getting to work to deliver Baby B.

First, the doctor needed to break Baby B's water. Well, she was hiding way up at the top of my uterus, starting to come down head first. But way up there. Not that Juliet had really come down too far -- apparently I accomplished the amazing feat of dilating to 10cm before she dropped, but this is common for my deliveries -- both Milo and Violet stayed high until I started pushing, then they were delivered quickly, managing to keep their little (ha!) heads nice and round.

So little miss hiding-way-up-there necessitated the doc getting his hand way up there, too, in order to hook her bag of water. The first attempt led to a trickle, so he made a second attempt, which led to a river which flowed so fast I involuntarily gasped, "Woah!"

According to Scott's mom (the OB nurse of some 30 years), once they know that Baby B is coming down the right direction, the OR relaxes. We certainly found that to be the case. The doctor and Super Nurse did a little bit of external repositioning and asked me to start pushing like mad, contractions or not. As she was crowing, they let me take a moment's rest before the final pushes.

Nine minutes after her sister (11:57 a.m.), Willa Caroline came into the world weighing 6lbs 6oz and measuring 20 inches long, completely covered with cheesy vernex. I was surprised that there was so much difference in their weights -- generally, the docs won't let you deliver vaginally if they think that Baby B is more than half a pound heavier than Baby A. Maybe it's a good thing we hadn't had that last growth ultrasound after all?

The nurses worked on the babies as I delivered the placentas and was repaired -- it's very odd to feel the tugging of stitches and have no associated pain. My tear was a second degree tear, but I didn't really feel it during recovery, thank goodness. Given that my first two babies were nearly 3 pounds bigger than Juliet, I'm guessing my tear had more to do with Dr. Large Hands than it did the actual births, but I'm not going to complain at all because I was able to deliver them the way I had so very much wanted.

Both babies did great -- Juliet had APGARs of 9/9 and Willa's were 8/9. Neither needed NICU time, both came back to the suite with me. I couldn't have asked for a more perfect twin delivery and am so very thankful and appreciative of the doctors and nurses who trusted me and my body to do it.

And that's my birth story for Mother's Day. I continue to be amazed by the four (FOUR!) little people Scott and I have brought into our lives. Every day fills me with more joy than I thought possible; I am continually humbled by the sheer force of their spirits. I feel pretty certain that I am the luckiest mama in the world.

Happy Mother's Day to all!

Saturday, May 7, 2011

Watching the Lights Go By

At around 6:00 a.m., the Evil Pitocin was started. I call it Evil Pitocin because I needed it to go into labor with Milo and can't say enough about how much I disliked how quickly the contractions settled in -- from 0 to 90mph in 30 minutes. Aware that using the Evil Pit caused my uterus to hyperstimulate with him (have contractions with two peaks), I had discussed the timing of my epidural very carefully with the night nurse.

I had decided that I only wanted to labor until just after the shift change without the epidural, since it was going to be necessary when Dr. Frying-Pan-Hands delivered the twins. I figured that any great anesthesiologist would love to come in on call on Monday morning and administer my epidural, right? Actually, I was mostly interested in having a "fresh" doctor because getting my epidural with Milo was rather, ummm... difficult. As in it took eleven tries.

Shift change rolls around and I still can't call my contractions any more painful than a 3 on the pain scale. And they aren't assembling into any ordered pattern at all. They were coming every 3 minutes, 5 minutes, 2 minutes, 7 minutes... You get the picture -- like a middle school orchestra plays through a piece of music for the first time -- not paying any attention to the conductor.

At shift change, we were given a treat -- a nurse whom Scott has known since he was a child and who also staffed Violet's birth came in as our nurse for the labor and delivery. We were thrilled!

The anesthesiologist come in, introducing himself and surveying my back. He proclaims it acceptable, saying, "We'll get this one on the first try!" And he did. Whew!!! I was honestly more worried about the epidural than the delivery. Not only that, but it appears to be a perfect epidural -- I can move and sense the pressure of the contractions, but feel none of the ouchies. After this experience, I can now understand why a woman would want an epidural. Don't get me wrong -- I still preferred my un-medicated birth with Violet, but this was a thousand times better than the way I felt with Milo.

Of course, as soon as the epidural was effective, I was overcome with nausea. Super Nurse put something into my IV that got rid o the nausea, but also put me to sleep for a couple of hours. Poor Scott had yet to close his eyes, but I was out deeply enough that I didn't even know that the on-call OB came in to chat with us about what was up. I surely hope Scott told him what I wanted. I think he did, though, as everything was pitch perfect all day.

At some point, S and the cameraman popped back in, wondering if there was a timeline for the day as no one really knew how long it would take. Super Nurse said, "Well, this isn't her first, so she could go from 2-10 pretty quickly. It doesn't usually happen that way and she's about 4 right now, but you never know."

I did rouse when Scott's mom came in to see how we were doing, mostly because I wanted to know how Milo and Violet were after their adventure of the previous night. About that time, I began to notice that the head lead on Baby A was moving. I could feel it twisting and turning and it occurred to me that A's head night be turning to get into place for delivery, so I said something to Super Nurse. She decided to check my progress and very quickly said, "Yep. She's complete."

Scott's mom decided to postpone the meeting she was about to attend and stuck her head out the door to let S and the cameraman know it was time to gown up. Scott climbed into the surgical jumpsuit, claiming that he looked "like a garbage man."

I was given an attractive shower cap, too, just before the bed went mobile and I was pushed into the OR. You always see shots in movies as a patient is being wheeled into surgery, dramatic music rising, weeping spouses begging the character to, "Hang on! I can't lose you!" and the camera pans to a shot of the lights whirring by overhead, clearly the patient's view. Aside from the melodramatics, the view of the lights is accurate, I can now vouch. I had that thought as I watched the lights go by...

Friday, May 6, 2011

So We Waited...

The words that slipped from my mouth to the receptionist at the birth care center seemed utterly surreal, "Hi. I'm 37 weeks pregnant with twins and my water has broken. I'm not in labor yet. Oh, by the way, I have called S. from the hospital and she will be here with a camera person shortly. They are completely OK to come in to triage or our room, wherever we are when they get here. And there should be a note in my file that my OB is planning to deliver me, even though she's not on call. And I'm Courtenay..."

I'm not sure which part was more crazy -- that the twins were on their way or that the little flighty introduction I gave the poor receptionist made me sound like I was Mariah Carey and we were checking into the celebrity wing of the hospital in L.A. whilst surrounded by paparazzi. In any case, I felt a wee bit self-conscious giving that whole self-important blah, blah, blah...

We were shown back to Room 2, the site of many of our non-stress tests. The tech asked a few questions, gave me a hospital gown and scooted out of the room to let me change. I made Scott take one last belly shot for the sake of weird science, and used the toilet. When I was attempting to stand up without dribbling amniotic fluid down my leg, our nurse arrived, escorted by a newly-minted charge nurse who just happened to be the daughter of a friend and who had staffed Violet's birth. I'm not sure who was more excited -- us or her.

I apologized profusely for leaking on the floor.

After going through the admission paperwork, I was hooked up to the old familiar monitors. Baby A was in the same spot as always, Baby B was sliding up and down the right side of my belly, naturally. I was not contracting in any pattern, commenting that the contractions I was having were less painful than the Braxton-Hicks I'd been having all week.

About this time, S and M (the cameraman) showed up for a quick interview, both looking tired and excited. I apologized for calling them out of bed, but neither seemed put out by it. M decided that he was going to shoot clocks throughout the piece, so, though I have no clue how long I was actually in triage, the video has the proof!

After confirming that my water had indeed broken, the nurses helped us organize our stuff and head to the suite where I would labor. Because I was having twins, the delivery would take place in an operating room in case we needed swift medical intervention, but I was able to labor in the comfort of a birthing suite, followed always by the swoosh-swoosh of the monitors.

I was still not contracting with any urgency, still only dilated to about 2cm. They started an IV with my antibiotics and fluids. My OB arrived on the scene, also looking sleepy. She explained that as luck would have it, the next morning was the only morning that she had surgery scheduled all week and, due to that, the on-call doc was going to have to do the delivery. I blinked and asked who the doc was...

Fortunately for us, the on-call doc was an OB who had been practicing longer than I've been alive -- so back in the day when they delivered breech babies vaginally instead of automatically checking the box for a c-section. I sighed with relief knowing that my body could deliver both babies vaginally if the doc was amenable and that the on-call doc was amenable. As she placed a scalp lead on Baby A, I mused that my OB has tiny delicate hands and the on-call doc towered over Scott and had hands the size of polar bear paws. I shuddered a little and decided that I was glad that I was going to have an epidural.

And then the waiting began. My doc decided not to start the pitocin right away to see if my body would get into a good labor pattern on my own. I didn't think that it would and had a deja vu moment as I remembered back to Milo's birth. My water broke then, too, and labor didn't start. Pretty much like it was going so far with the twins.

And so we waited. Scott and I were far too awake to relax, he was bouncy with anticipation. My contractions weren't painful, strong, nor long. So we waited...

Wednesday, May 4, 2011

Into the Unknown

Instantly life sped up. Scott flew out of the bed, thanking his intuition for not taking the Ambien, and we started planning what our next steps were.

"We've got to call someone to watch the kids. Should we have someone come here? Should we take them somewhere?"

"What about the dogs? They're going to have to stay outside for the night."

"Must call S. from the hospital so she can alert the camera crew. Yikes! We'll be waking them in the middle of the night..."

"I'm going to be a little vain and take five minutes to put on some make-up. I think we're going to be up all night and I just don't want to look like Frankenstein's monster on TV."

I got myself ready and Scott bustled about dressing himself, loading the few things that needed to be loaded in the van, and finally carrying each of our children through the cold rain to their car seats.

By the time I got to the van, they were both wide awake and grinning from ear to ear. In unison, they squealed, "I love you, mommy!" as I ungracefully climbed into my seat and onto the thick beach towel Scott had laid out to soak up the amniotic fluid.

"Do you know what we're doing up in the middle of the night?"

"Daddy says we're having the babies!!" Violet pealed, her smile shining in the darkness like a beacon. Milo shouted, "Yay for babies"

And we were off in the night to meet Scott's mom at the birth care center so that she could take the kids and we could get admitted. i still was not contracting.

I placed the call to S. from the hospital, she answered sleepily, but became quickly excited when I told her that my water had broken. She said she'd get the ball rolling with the film crew and wished us good luck for a safe drive through the downpour. I called my mom and told her what was up, asking her not to drive out in the middle of the night because I wasn't actually in labor yet, so I anticipated a lunchtime arrival of the babes.

We pulled up under the awning of the birth care center and Scott's mom came out, looking both sleepy and excited. I kissed each of the kids good night, feeling very sad to send them along, even though they were bursting at the seams with pride and excitement. I was remembering how hard it was for me to miss Milo for the few days I was in the hospital with Violet's birth.

It was cold out, and in the whirlwind to get to the hospital, I had not grabbed a jacket, so I shivered in the cold wind as Scott closed the van doors on our family of four for the last time.

We made our way into the darkened lobby of the birth care center, taking deep breaths as we stepped off the edge into the unknown.

Tuesday, May 3, 2011

Yes, I'm Fine... Actually, My Water Broke

Sunday, April 17 dawned like any other muddy spring day here in Iowa. The mischievous sparkle of a spring snow that had dusted the previous morning was long gone, but the whine of the spring wind wrapped itself around the house, making a melancholy song.

I was restless. And very uncomfortable, perhaps more uncomfortable than I had been during the entire twin pregnancy. Uncomfortable enough to need a shower, breaking my one-ness with the couch for long enough to actually shave my legs. That is, by the way, a real feat for a beyond hugely pregnant mama in a smallish shower. Yes, I felt absolutely compelled to shave my legs.

My pelvic bone felt like it was breaking in two and I was actually flopping around on the couch like a turtle on it's back. I chanted silently every time I moved, "One more week. Hang on for just a little longer..."

Scott's parents brought dinner that night. I think they were missing my lovely Milo and Violet, but it was nice to eat something not frozen, then warmed or carried out from who-knows-where. I commented to his mother that I was feeling about done with being pregnant, that 37 weeks was tomorrow.

TMI alert (sorry, Dad): Shortly after they left, I discovered I was losing my mucous plug. I laughed loudly from the bathroom. Scott misheard and thought I was calling for help, so he came bounding through the house like a herd of elephants to see what was up. I said, "I'm losing my plug here. That just means I'm moving closer to labor, but it could be hours or weeks. Not a hard sign of anything."

Still, even though I was approaching labor and delivery for the third time in my life, the excitement began welling. It may sound naive, but I felt pretty certain at that moment that I wasn't going to make it to 38 weeks. Scott seemed to sense my restlessness and decided that it was the night for him to stop taking the Ambien -- just in case.

Neither of us fell into a deep sleep. The girls were having a dance party, using my bladder for a trampoline, so I was up four times to use the bathroom before 1:00.

At 1:20, as I was laying there in the darkness, listening to Scott's breathing become rhythmic and deep, I felt the telltale POP and a small gush. I quickly rolled out of bed, not wanting to flood the mattress. Scott stirred slightly. I made my way to the bathroom in a trance. Sat down, could tell that the trickle of liquid was not coming from my bladder. Sleepwalked back to the bedroom, where I stood poised at the foot of the bed, not quite sure how to wake Scott.

He roused slightly, and asked a perfunctory, "You OK?"

I stammered, "Yes, I'm fine... Actually, my water broke..."

Monday, May 2, 2011

A Picture is Worth a Thousand Words (Give or Take)

With eight little feet
Our family is complete!

We welcomed to our family Juliet Diana (5lbs 8oz and 19 inches) on April 18 at 11:47 a.m. and Willa Caroline (6lbs 6oz and 20 inches) at 11:56 a.m. Mommy was so glad to not have a c-section!

Pictured above in Violet's arms is Willa and Milo is holding Juliet.

More details to come when I'm a bit more awake. This is definitely NOT anything like bringing home one baby...